1851869069 NPI number — OSLER MEDICAL GROUP LLC

Table of content: (NPI 1851869069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851869069 NPI number — OSLER MEDICAL GROUP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OSLER MEDICAL GROUP LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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NPI Number Information

NPI Number:
1851869069
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 UNITED DR STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST BRIDGEWATER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02379-1027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-238-8646
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
795 TURNPIKE ST STE 201-202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH ANDOVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01845-6128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-296-3781
Provider Business Practice Location Address Fax Number:
978-296-3783
Provider Enumeration Date:
11/06/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOLLMAN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
978-296-3781

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)